Hand & Wrist Tumours

Any abnormal mass, lump or bump in the hand or wrist is considered a “tumour”. The majority are benign (non-cancerous) and there are many potential causes.

They can originate from or involve any tissues or structures of the hand including skin, fat, tendons, ligaments, blood vessels, nerves and bone.

The most common “tumour” of the hand and wrist is a ganglion cyst. The 2nd most common hand tumour is a giant cell tumour of tendon sheath. These are more solid than fluid-filled ganglion cysts and occur near the outer lining layer of a tendon (sheath). They are benign and slow-growing.

Another common tumour of the hand is an epidermal inclusion cyst. It is also benign and originates from the skin cells that get trapped under the surface from trauma such as a cut or puncture. The skin cells produce keratin, which collects in a cyst-like structure.  

Less common types of tumours of the hand include lipomas (fat), neuromas (nerve), nerve sheath tumours, fibromas and glomus tumours. Bone spurs can form from trauma or arthritis and feel like tumours. Foreign bodies such as wood splinters, glass or ceramic can cause reactions that also feel like tumours in the hand.

The finding of a lump or bump in the hand or wrist can be distressing, as often one’s first thought is cancer. Fortunately, cancer is extremely rare in the hand. The most common cancers that originate in the hand are skin cancers such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or melanoma. Other even rarer cancers include sarcomas of the soft tissue or bone. Cancer may also spread to the hand or wrist from other locations, such as lung or breast.

A careful history and examination by a hand surgeon can help determine the type of hand or wrist tumour. Imaging in the form of x-rays, ultrasound, CT, MRI or bone scans may be requested to better define the tumour. Biopsies of skin cancers are generally performed prior to any treatment decisions.

Recommendations for treatment are based on the history, examination, investigations and likely diagnosis determined by an experienced hand surgeon. Surgical excision of the tumour typically provides definitive treatment with the lowest recurrence rate. All tumours are analysed by a pathologist to confirm or provide more clarity to the diagnosis. 

Further treatment may be required based on the diagnosis or in the event of recurrence.